Exam (elaborations)
Pharmacology Exam #3 - University of Cincinnati (QUESTIONS WITH ANSWERS)
- Course
- Pharmacology (PHARMACOLOGY)
- Institution
- University Of Cincinnati
Pharmacology Exam #3 - University of Cincinnati (QUESTIONS WITH ANSWERS)
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Pharmacology Exam #3 - University of Cincinnati(QUESTIONS WITH ANSWERS)
What is the pathophysiology of Parkinson's Disease? - **🔰 VERIFIED ANSWERS🔰
✔✔Progressive neurological disorder of muscle movement, characterized by tremors,
muscle rigidity, bradykinesia and postural and gait abnormalities
--> Degree of dopamine loss correlates w/ severity of motor symptoms
Etiology: destruction of dopaminergic neurons in the substantia nigra
• results in reduction of dopamine action in brain basal ganglia → affects motor control
• Unknown cause: Theory- partially environmental w/ a genetic component →
predisposition to disease
What are the symptoms of Parkinson's and the pharmacological goals to treat it? - **🔰
VERIFIED ANSWERS🔰 ✔✔r/t imbalance between excitatory cholinergic neurons and
greatly diminished numbers of inhibitory dopaminergic neurons
Pharm goals:
• to restore dopamine in the basal ganglia and antagonizing the excitatory effect of
acetylcholine at the muscarinic receptors
• → reinstates dopamine/acetylcholine balance
• Drugs provide temporary relief from symptoms
• Does not arrest or reverse the neuronal degeneration caused by the disease
What are the cautions/warnings and use for Cogentin? - **🔰 VERIFIED ANSWERS🔰
✔✔It is an anticholinergic drug used for Parkinson's
Cautions/Warning:
,-in elderly, BPH, urinary retention, liver, renal or GI or GU disease
-Can precipitate narrow-angle glaucoma
What is the drug Pramipexole (Mirapex)? - **🔰 VERIFIED ANSWERS🔰 ✔✔A Dopamine
Receptor Agonist
effective mild parkinsonism, used in combination w/ levadopa
• Also used in restless leg syndrome
ADE: N/V, anorexia, postural hypotension, dyskinesias
- CNS: confusion, delusions, hallucinations, impulsivity
• (Psych ADE more common than with levodopa) •
Monitor: renal function, caution w/ other drugs w/ renal implications
What is the drug Ropinirole? - **🔰 VERIFIED ANSWERS🔰 ✔✔A Dopamine Receptor
Agonist
effective mild parkinsonism, also used in combination w/ levadopa
• Also used in restless leg syndrome
ADE: similar to pramipexole
What is Levadopa and carbidopa (Sinemet)? - **🔰 VERIFIED ANSWERS🔰 ✔✔A
Dopamine Precursor
- Enhances synthesis of dopamine in surviving neurons of the substantia nigra conversion
of levodopa to dopamine
• Consistent therapeutic response in new patients
• Over time, number of neurons decreases
• Relief provided by levodopa only symptomatic
,• lasts only while the drug is present in the body.
Mechanisms of Action
Levadopa:
• Attempts to replace dopamine that is deficient
• Levadopa can cross BBB and convert to dopamine in the brain (lg. doses required)
Carbidopa:
• Enhances effect of levadopa via diminishing metabolism of levadopa in GI tract and
peripheral tissues...
• → Increasing availability of levadopa to cross into the CNS
What is the treatment plan with Levadopa & carbidopa? - **🔰 VERIFIED ANSWERS🔰
✔✔• Potent & effective in treatment
Action: Levodopa decreases rigidity, tremors, & other symptoms
• levodopa-carbidopa Rx -
• significantly reduces severity of dx symptoms in first few yrs of Tx in about 2/3 of patients
w/ Parkinson's Dx
• Typical decline in response in 3rd to 5th year of Tx
What are the general points in treatment for Parkinson's? - **🔰 VERIFIED ANSWERS🔰
✔✔• First line therapy: levodopa, dopamine agonists
• Carbidopa/levodopa most effective
MAOI: selegline, rasagiline
• Mild symptoms or with levadopa
, Pramipexole and ropinirole:
• effective in early and late Parkinson's
Amantadine: patients w/ mild symptoms
Anticholinergics: reduce tremor, rigidity and drooling (limited use d/t ADE)
COMT inhibitors: reduces motor fluctuations in advanced dx- but increase dyskinesias
(adjunctive tx)
What is the pathophysiology of Alzheimers Disease? - **🔰 VERIFIED ANSWERS🔰 ✔✔•
most common cause of dementia
• 50- 60% of late-life cognitive dysfunction
• characterized by progressive memory impairment, dementia, & cognitive dysfunction
• Prevalence ↑ w/ age and may be as high as 20% in individuals over 85
• Estimated cost: $150-215 billion annually
• familial and sporadic forms
What are the different types of Alzheimers? - **🔰 VERIFIED ANSWERS🔰 ✔✔1)
accumulation of senile plaques (β-amyloid)
2) formation of numerous neurofibrillary tangles
3) loss of cortical neurons—particularly cholinergic neurons
What is the aim of pharmacologic therapy in Alzheimers? - **🔰 VERIFIED ANSWERS🔰
✔✔• aimed at improving cholinergic transmission w/i the CNS
• or preventing excitotoxic actions resulting from overstimulation of NMDA-glutamate
receptors
• Pharmacologic intervention is palliative and provides modest shortterm benefit
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